In Massachusetts, an injured worker can receive workers’ compensation benefits for a work-related injury that aggravated a pre-existing condition as long as the injury is a major cause of the disability. This differs from the requirements for psychiatric injuries under G. L. c. 152, § 1(7A), which place a higher burden on the injured person to show the workplace injury was the predominant contributing cause. To determine whether or not the work-related injury rises to this standard, the Administrative Judge (AJ) hears from medical experts who have either examined the worker or looked at the injured person’s records. An award of benefits hinges on whether or not there is sufficient evidence to support the claim of psychiatric disability.

In a recent case (16-P-837), the Appeals Court reviewed an appeal of a decision of the Department of Industrial Accidents (DIA) reviewing board, which reversed an AJ’s decision in favor of the injured worker. The board determined the injured woman did not show the employment-related event was the predominant contributing cause. The injured worker appealed, arguing the decision should have been affirmed, or in the alternative, recommitted to the AJ for additional findings. The claim originated from the worker’s repeated encounters with clients through the Department of Transitional Assistance (DTA) who were verbally hostile and threatening. The woman sought psychiatric treatment in 1997 after working there for several years, but she had a stressful incident in 2013 when she was threatened by a client during an interview. The worker sought help from a supervisor but received no support. Paralyzed by anxiety, the injured worker did not return to work.

Prior to her employment, the woman suffered physical and emotional abuse from her mother. The woman did not have any family support, nor any mental health treatment during this period. During the hearing with the AJ, the independent medical examiner testified that her childhood experiences and experiences at work contributed to her diagnosed mental health disorders. The doctor affirmed that she was medically disabled and that the cause of this disability stemmed from the combined experiences. The doctor testified that after several years of traumatic incidents, the threatening client at work in 2013 was the “proverbial straw that broke the camel’s back.” In its review, the board concluded this was not enough to show the work-related incidents were the predominant cause of her disability.

The Appeals Court pointed out it cannot reverse a board’s decision unless the decision was beyond the scope of authority, arbitrary or capricious, or contrary to law. The appellate court does not make a determination on whether there was or wasn’t substantial evidence to support the conclusion. The Appeals Court noted that the language used by a testifying IME does not have to line up with the language of the statute for a claim to be awarded. The opinion must be expressed in terms substantially equivalent to the statute. While the medical examiner revealed that both work-related events and childhood trauma contributed to her disability, the court felt the examiner did not address the degree to which the work-related event contributed to the claimed disability. Because of this, the court concluded the board’s decision to reverse the AJ’s award of benefits was not arbitrary or capricious. The appellate court also did not think recommitment would have assisted the injured party, since case law does not allow an AJ to reopen the evidence. With no possibility of additional evidence, the decision of the reviewing board was affirmed.

The Massachusetts workers’ compensation attorneys at Karsner & Meehan can help you with your work-related psychiatric injury claim. Our lawyers can aggressively pursue the benefits for which you qualify. Contact our office today for a free, confidential consultation at 508.822.6600.